Prostate Cancer: What You Need to Know

02 September 2020

Prostate cancer is common in men but despite the symptoms, some men still feel ashamed to do a prostate examination. Sunway Medical Centre Consultant Clinical Oncologist, Dr Nik Muhd Aslan Abdullah shares some insight on this disease.

Among the stigma that men experience is the feeling of shame and embarrassment to see a doctor for a prostate examination. Some even consider their symptoms of urinary incontinence and back pain to be common among the elderly.

Also, the fear of being diagnosed with prostate cancer and fear of undergoing surgery occurs among those who are older, hence raising the awareness and educating the public is crucial in overcoming these stigmas.

However, education on prostate cancer should not focus on the symptoms alone. It is also important to know the type of treatments because not all cancers require surgery.

Those who are at risk of prostate cancer are those who have a family history of the disease. Age is also another risk where the risk increases with person’s age. Prostate cancer is rare for men under the age of 40 but after the age of 50, the risk increases and can be as high as 60% when approaching the age of 90.

Signs and Symptoms of Prostate Cancer

  • Weak or intermittent urination
  • The feeling of unable to urinate and needing to go to the bathroom immediately
  • Frequent waking up at night to urinate
  • Difficulty in starting to urinate
  • Difficulty in urinating completely
  • Pain or feeling of tenderness during urination
  • Blood in urine or semen
  • Pain in the spine, thighs or back that does not go away
  • Signs of anaemia such as shortness of breath, fatigue, paleness

There are many advances in prostate cancer treatment technology in terms of surgery and radiotherapy. Now, there are robotic surgeries with the advantage of lesser complications and faster patient recovery.

Today, there are various new radiotherapy treatments that produce more accurate treatment with higher success rates and fewer side effects. Among these new radiation treatments are intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT), Tomotherapy, Stereotactic Body Radiotherapy, Brachytherapy and radioactive seed implants.

In terms of medicine, there are a wide selection of pills that can control prostate cancer for a longer period of time than before. Studies are also being conducted in the use of targeted therapy pills for prostate cancer.

With the advent of new medicine, chemotherapy is now only given for certain cases. There are also more options for medications to control the symptoms of prostate cancer such as anti-pain patches and long-lasting morphine drugs with fewer side effects.

The probability of successful treatment for prostate cancer depends on the stage of the cancer when it is detected. Stage 1 prostate cancer has a higher chance of recovery than Stage 3 prostate cancer.

There are several reasons why multi-disciplinary experts are highly recommended. One of the reasons is that prostate cancer is more common in the elderly, and this group may have chronic diseases such as high blood pressure, diabetes and heart disease. And they may need treatment for these diseases while undergoing prostate cancer treatment.

Apart from that, prostate cancer treatment does not only involve oncologists and urologists. For those detected at Stage 4, the involvement of other disciplines such as palliative specialists are important. There are also some patients who complain of spinal pain where an emergency spinal surgery may be needed, and for this a spine specialist should be called.

Prostate Cancer Cases

Case 1

The patient complained of abdominal pain and severe bowel problems. An examination found that his prostate was swollen and was pressing on his rectum causing his intestines to become clogged. A surgeon is called for a surgery to be performed. Unfortunately, his intestines were already leaking and was needed to be admitted to the ICU. After recovering from surgery and a bacterial infection due to a leaky gut, he underwent radiotherapy and took medication for prostate cancer.

Case 2

The patient was taken to the emergency room with back pain and with both legs half paralysed. Immediate radiotherapy treatment was performed over a long public holiday. This is because a delay in treatment can cause him to be paralysed forever. After a few months and with physiotherapy treatment, his legs have become strong again and he is able to walk again.

Case 3

The patient’s prostate cancer recurred and has advanced to Stage 4. He undergone hormone and chemotherapy treatment while the cancer is still active. At that time, a new drug was discovered and was not yet available in Malaysia. Radiotherapy treatment for bone pain was performed and he also went on steroid treatment.

This treatment can help control his cancer until the latest medicine can be obtained. He was given the new drug as one of the subjects in a clinical study. The new drug was able to control his cancer for several years and he became the longest-serving patient taking the drug in the international study.

Source: Mingguan Wanita